Just spent time today talking with a family about their child’s communication under the frame of social development. Seems strange for many people that OT’s talk about communication and for specialised input we would always refer on to a speech pathologist for advice, however communication is part of a child’s function and occupation so obviously we would chat about this as well. During a session we were celebrating how much a child was spontaneously imitating, orienting frequently to adults, anticipating what was going to happen, sharing attention between objects and people and joining in cooperative actions. There were so many social foundation skills displayed we have stopped counting the frequency because we just can’t keep up. How wonderful to see these social scaffolds improving a child’s attention and desire to learn through the frame of another person. What was interesting was when I probed further, one of the parents felt the child’s communication hadn’t come on very much. As we chatted further it became more apparent that the family felt the child’s language hadn’t come on rather than the overall communication. I phrased it like this and credit needs to be given to Louise Ulliana who’s knowledge, collaboration and Functional Assessment of Expressive Skills has shaped my view greatly. Initially when the family’s child came he only communicated to get what he wanted. It was all requesting or leading behaviours and there wasn’t any sharing of experiences. The child’s expressive communication profile would have looked similar to the one below.


The child was building one or two communication towers and they were all about getting things he wanted or indicating he didn’t want something. Now we could have focussed on the the child developing their requesting of needs and wants and kept building a requesting skyscraper, but instead we focussed on social connectedness, the social foundation skills, interaction and play. After a couple of months his communication profile would probably look similiar to the following profile. Instead of a skyscraper we are starting to get more of a town.


What the newer profile means is:

  1. The child has lots more opportunities across the day to practice language and expression as she is interacting more due to the social relating strengthening.
  2. His language profile is not just about getting what he wants or reciting videos but includes lots of sharing language like “train on the swing”. This language is about commenting and connecting rather than illiciting a response from another person.
  3. There is a wider base on which to build language so language is now the “icing on the communication cake”.
  4. We have lots more opportunities for functional interaction and play skills.

So in essence although the child is possibly not saying any more words that he did, he is now saying words with communicative intent and to share experiences in a social way. He is moving from a non-communicative talker to a person who talks to communicate. Remember social connection is the cake, you need the cake first then the language icing on top.

Aaron Jackson

BAppSc (OT); MHlthSc (OT)

Occupational Therapist